HomeMy WebLinkAboutAgreement A-15-317-2 with Kings View.pdfCOUNTY OF FRESNO
Fresno, CA
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AMENDMENT II TO AGREEMENT
THIS AMENDMENT, hereinafter referred to as “Amendment II”, is made and entered into
this _____ day of _____________, 2020, by and between the COUNTY OF FRESNO, a Political
Subdivision of the State of California, hereinafter referred to as “COUNTY”, and KINGS VIEW
BEHAVIORAL HEALTH, whose address is 7170 North Financial Drive, Suite 110, Fresno, California,
93720, hereinafter referred to as “CONTRACTOR” (collectively as the “parties”).
WHEREAS, the parties entered into that certain Agreement, identified as COUNTY Agreement
No. 15-317, effective July 1, 2015, as amended by COUNTY Amendment No. 15-317-1, effective July
10, 2018, hereinafter collectively referred to as COUNTY Agreement No. 15-317, whereby
CONTRACTOR agreed to provide Rural Mental Health Triage Services (Rural Triage Services) in
East and West rural Fresno County cities; and
WHEREAS, the parties desire to amend COUNTY Agreement No. 15-317, regarding changes
as stated below and restate the Agreement in its entirety.
NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which
is hereby acknowledged, the parties agree to amend the Agreement as follows:
1.That the following be added to existing COUNTY Agreement No. 15-317, Section Two
(2)“TERM”, as set forth in the original Agreement, at Page Three (3), Line Two (2) after the number
“2018”:
“The term of this Agreement shall be extended for an additional twelve (12) month
period beginning July 1, 2020 and shall terminate on June 30, 2021.”
2.That the existing COUNTY Agreement No. 15-317, Section Four (4)
“COMPENSATION”, as set forth in the original Agreement, Page Four (4), beginning with Line Six (6),
with the word “The” and ending on Page Six (6), Line Twenty-Six (26) with the number “($0.00)” be
deleted and the following inserted in its place:
“4. COMPENSATION
The maximum compensation amount under this Agreement for Rural Triage
Services in East Fresno County and West Fresno County combined for the period July 14, 2015
through June 30, 2021, shall not exceed Fourteen Million, Eight Hundred Sixty-Three Thousand, Five
Agreement No. 15-317-2
28th April
COUNTY OF FRESNO
Fresno, CA
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Hundred Fifteen and No/100 Dollars ($14,863,515.00).
East Fresno County
The maximum compensation amount under this Agreement for East Fresno County
Rural Triage Services for the period July 14, 2015 through June 30, 2021, for all funding and revenue
streams collectively shall not exceed Eight Million, One Hundred Fifty-Four Thousand, Eight Hundred
Ninety and No/100 Dollars ($8,154,890.00).
The maximum compensation amount under this Agreement for East Fresno County
Rural Triage Services for the period of July 14, 2015 through June 30, 2016, shall not exceed One
Million, Three Hundred Thousand, Four Hundred Thirty-One and No/100 Dollars ($1,300,431.00).
The maximum amount of SB 82 funding under this Agreement during said time period shall not
exceed Eight Hundred, Forty-Nine Thousand, Six Hundred Fifty-Three and No/100 Dollars
($849,653.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate Four Hundred Fifty Thousand, Seven Hundred Seventy-Eight and No/100
Dollars ($450,778.00) in Medi-Cal Federal Financial Participation (FFP) to offset CONTRACTOR’s
program costs.
The maximum compensation amount under this Agreement for East Fresno County
Rural Triage Services for the period of July 1, 2016 through June 30, 2017, shall not exceed One
Million, Two Hundred Eighty-Eight Thousand, One Hundred Twenty-Four and No/100 Dollars
($1,288,124.00). The maximum amount of SB 82 funding under this Agreement during said time
period shall not exceed Eight Hundred Forty-Two Thousand, One Hundred Twenty-Two and No/100
Dollars ($842,122.00). In addition, it is understood by CONTRACTOR and COUNTY that
CONTRACTOR estimates to generate Four Hundred Forty-Six Thousand, Two and No/100 Dollars
($446,002.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.
The maximum compensation amount under this Agreement for East Fresno County
Rural Triage Services for the period of July 1, 2017 through June 30, 2018, shall not exceed One
Million, Three Hundred Twenty-Seven Thousand, Three Hundred Twenty-Two and No/100 Dollars
($1,327,322.00). The maximum amount of SB 82 funding under this Agreement for said time period
shall not exceed Eight Hundred Sixty-Seven Thousand, One Hundred Sixty-Eight and No/100 Dollars
COUNTY OF FRESNO
Fresno, CA
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($867,168.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate Four Hundred Sixty Thousand, One Hundred Fifty-Four and No/100 Dollars
($460,154.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.
The maximum compensation amount under this Agreement for East Fresno County
Rural Triage Services for the period of July 1, 2018 through June 30, 2019, shall not exceed One
Million, Three Hundred Seventy-Five Thousand, Nine Hundred Fifty-Two and No/100 Dollars
($1,375,952.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate Three Hundred Thousand, Three Hundred Sixty and No/100 Dollars
($300,360.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.
The maximum compensation amount under this Agreement for East Fresno County
Rural Triage Services for the period of July 1, 2019 through June 30, 2020, shall not exceed One
Million, Four Hundred Ten Thousand, Three Hundred Seventy-Five and No/100 Dollars
($1,410,375.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate Three Hundred Thousand, Three Hundred Sixty and No/100 Dollars
($300,360.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.
The maximum compensation amount under this Agreement for East Fresno County
Rural Triage Services for the period of July 1, 2020 through June 30, 2021, shall not exceed One
Million Four Hundred Fifty-Two Thousand, Six Hundred Eighty-Six and No/100 Dollars
($1,452,686.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate Four Hundred Eighty-Two Thousand, Eight Hundred Eighty-One and No/100
Dollars ($482,881.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.
West Fresno County
The maximum compensation amount under this Agreement for West Fresno County
Rural Triage Services for the period October 1, 2015 through June 30, 2021, shall not exceed Six
Million, Seven Hundred Eight Thousand, Six Hundred Twenty-Five and No/100 Dollars
($6,708,625.00).
The maximum compensation amount under this Agreement for West Fresno County
Rural Triage Services for the period of October 1, 2015 through June 30, 2016, shall not exceed Nine
COUNTY OF FRESNO
Fresno, CA
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Hundred Eight Thousand, Four Hundred Twenty and No/100 Dollars ($908,420.00). The maximum
amount of Public Safety Realignment funding under this Agreement for said time period shall not
exceed Thirty-Three Thousand, Seven Hundred Thirty-Two and No/100 Dollars ($33,732.00). The
maximum amount of Mental Health Services Act (MHSA) funding under this Agreement for said time
period shall not exceed Five Hundred Fourteen Thousand, Seven Hundred Twenty-One and No/100
Dollars ($514,721.00). In addition, it is understood by CONTRACTOR and COUNTY that
CONTRACTOR estimates to generate Three Hundred Fifty-Nine Thousand, Nine Hundred Sixty-
Seven and No/100 Dollars ($359,967.00) in Medi-Cal FFP in this term to offset CONTRACTOR’s
program costs.
The maximum compensation amount under this Agreement for West Fresno County
Rural Triage Services for the period of July 1, 2016 through June 30, 2017, shall not exceed One
Million, Eighty-Nine Thousand, Five Hundred Fifty and No/100 Dollars ($1,089,550.00). The
maximum amount of MHSA funding under this Agreement for said time period shall not exceed Six
Hundred Forty-Three Thousand, Five Hundred Forty-Eight and No/100 Dollars ($643,548.00). In
addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR estimates to
generate Four Hundred Forty-Six Thousand, Two and No/100 Dollars ($446,002.00) in Medi-Cal FFP
in this term to offset CONTRACTOR’s program costs.
The maximum compensation amount under this Agreement for West Fresno County
Rural Triage Services for the period of July 1, 2017 through June 30, 2018, shall not exceed One
Million, One Hundred Twenty-Two Thousand, Seven Hundred Ninety-One and No/100 Dollars
($1,122,791.00). The maximum amount of MHSA funding under this Agreement in this term shall not
exceed Six Hundred Sixty-Two Thousand, Six Hundred Thirty-Seven and No/100 Dollars
($662,637.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate Four Hundred Sixty Thousand, One Hundred Fifty-Four and No/100 Dollars
($460,154.00) in Medi-Cal FFP for said time period to offset CONTRACTOR’s program costs.
The maximum compensation amount under this Agreement for West Fresno County
Rural Triage Services for the period of July 1, 2018 through June 30, 2019, shall not exceed One
Million, One Hundred Sixty-Five Thousand, Two Hundred Eighty-Six and No/100 Dollars
COUNTY OF FRESNO
Fresno, CA
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($1,165,286.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate One Hundred Nine Thousand, Eight Hundred Ninety-Five and No/100 Dollars
($109,895.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.
The maximum compensation amount under this Agreement for West Fresno County
Rural Triage Services for the period of July 1, 2019 through June 30, 2020, shall not exceed One
Million, One Hundred Ninety-Three Thousand, Three Hundred Eighty-Eight and No/100 Dollars
($1,193,388.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate One Hundred Nine Thousand, Eight Hundred Ninety-Five and No/100 Dollars
($109,895.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.
The maximum compensation amount under this Agreement for West Fresno County
Rural Triage Services for the period of July 1, 2020 through June 30, 2021, shall not exceed One
Million, Two Hundred Twenty-Nine Thousand, One Hundred Eighty-Nine and No/100 Dollars
($1,229,189.00). In addition, it is understood by CONTRACTOR and COUNTY that CONTRACTOR
estimates to generate One Hundred Eighty-Three Thousand, Five Hundred Sixty-Seven and No/100
Dollars ($183,567.00) in Medi-Cal FFP to offset CONTRACTOR’s program costs.”
2.That, effective July 1, 2020, all references in existing COUNTY Agreement No. 15-317
to “Revised Exhibit C ‘East’” and “Revised Exhibit C ‘West’” shall be changed to read “Revised Exhibit
C and C-1 ‘East’” and “Revised Exhibit C and C-1 ‘West’”, respectively.
3. Revised Exhibit C-1 “East” and Revised Exhibit C-1 “West” are attached hereto and
incorporated herein by reference.
4.That the existing COUNTY Agreement No. 15-317, Section Seven (7)
“MODIFICATION”, as set forth in the original Agreement, Page Fourteen (14), beginning with Line
Nine (9), with the word “Notwithstanding” and ending on Page Fourteen (14), Line Sixteen (16) with
the word “herein” be deleted and the following inserted in its place:
“7. MODIFICATION
Notwithstanding the above, changes to services, staffing and responsibilities of
the CONTRACTOR, as needed, to accommodate changes in the laws relating to mental health and
substance use disorder treatment, as set forth in Exhibit A, may be made with the signed written
COUNTY OF FRESNO
Fresno, CA
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approval of COUNTY’s DBH Director, or designee, and CONTRACTOR through an amendment
approved by COUNTY’s County Counsel and the COUNTY’s Auditor-Controller/Treasurer-Tax
Collector’s Office.
In addition, changes to expense category (i.e., Salary & Benefits,
Facilities/Equipment, Operating, Financial Services, Special Expenses, Fixed Assets, etc.) subtotals
in the budgets, and changes to the volume of units of services/types of service units to be provided,
as set forth in Revised Exhibit C and C-1 “East” and Revised Exhibit C and C-1 “West”, that do not
exceed ten percent (10%) of the maximum compensation payable to the CONTRACTOR may be
made with the written approval of COUNTY’s DBH Director, or designee. Changes to the expense
categories in the budgets that exceed ten percent (10%) of the maximum compensation payable to
the CONTRACTOR may be made with the signed written approval of COUNTY’s DBH Director, or
designee, through an amendment approved by COUNTY’s Counsel and COUNTY’s Auditor-
Controller/Treasurer-Tax Collector’s Office.
Said modifications shall not result in any change to the maximum compensation
amounts payable to CONTRACTOR, as stated in this Agreement.”
5.COUNTY and CONTRACTOR agree that this Amendment II is sufficient to amend the
Agreement; and that upon execution of this Amendment II, the Agreement, Amendment I and
Amendment II together shall be considered the Agreement.
The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
covenants, conditions and promises contained in the Agreement, and not amended herein, shall
remain in full force and effect.
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IN WITNESS WHEREOF, the paroes here!o ~ axea.lled this .Amendrnem ii to COUNTY
Agreement No. ~5-317 as of the day and year first ~ ie.~.
Print Name: _Amanda Nugent Dimne __
Title: __ Chief Executive Officer __ _
Ct\aim1,an of ~d. ~
President, or any Vice President
COONTYOFFRESNO
Ernest Btrd'rl'( l\-~rr s . Charrman of ~e
Boom of Supervisoi"S of ttie County of Fresno
ATTEST. J J !
::11::6~ BE.Rl\!!ICE IE . SEIDEL
C!!em to She Boa,d1 of &.YpetVlSOO-S
~ty _of Fresoo, Stare of Ca'iitomia
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Tille: ........,.~_Chief Financial C>fficef" __
Secretary (of Corporation), or
any Assistant Secretary, or
Chief Financial Officer. or
any Assistant Treasurer
Mailing Address.:
l(cngs V~· Behawx~ Heol&
7170 J\lofth Ftnaneral Avenue .. Su~ t il<D
Fresno. CA 93720
FOR ACCOUNTING PURPOSES O"N!LV :
FundJS1!>c:las.t;: 0001J1·00DO
Account..'Program : 7295ffi
OrganiZation: 56304766 East
56~767 ·~
FY 2015-16: Sl.300.431
Fv w~&-rr·. s:2.:rrr .674
FY 2017-rn : S2.450.113
FY 2018-19:: S2.~-1.238
FY 2019--20~ S2.603. T63
FY 2020-21: $2,681,876
TOTAL; $14,863,515
EAST
$1.300.431
S 1. .'2138.f."24-
S L327 .322
:s~ .. 375 .. 952
51.410.315
$1,452.686
WESl
s S-08 .4...?G qg mo..rMs)
'£f..OO~.~
51 .122 ,79~
$1,165.286
51i .193,3SS
S~.229,1$?
Revised Exhibit C-1
Page 1 of 14
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Program Oversight 0.27 -$ 33,553$ 33,553$
1102 Clinical Supervisor 0.55 58,779 58,779
1103 Program Manager 0.55 - 71,523 71,523
1104 Clinician (2 unlicensed, 5 Licensed)7.00 - 641,516 641,516
1105 Per Diem Team Responders (Licensed)0.45 - 37,137 37,137
1106 Program Staff Accountant 0.11 - 5,967 5,967
1107 Administrative Support 0.40 - 19,427 19,427
1108 - -
1109 - - -
1110 - - -
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 9.33 -$ 867,902$ 867,902$
Employee Benefits
Acct #Admin Direct Total
1201 -$ 15,364$ 15,364$
1202 - 25,883 25,883
1203 - 111,259 111,259
1204 - - -
1205 - - -
1206 - - -
-$ 152,506$ 152,506$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 -$ -$ -$
1302 - 66,395 66,395
1303 - 6,509 6,509
1304 - - -
1305 - - -
1306 - - -
-$ 72,904$ 72,904$
-$ 1,093,312$ 1,093,312$
Employee Benefits Subtotal:
Description
1000: SALARIES & BENEFITS
Retirement
Worker's Compensation
Health Insurance
Other (Specify)
Other (Specify)
OASDI
FICA/MEDICARE
SUI
PROGRAM EXPENSES
Other (Specify)
Other (Specify)
EMPLOYEE SALARIES & BENEFITS TOTAL:
Other (Specify)
Other (Specify)
Rural Mental Health Triage - East
Kings View Corporation
Fiscal Year (FY 2020-21)
Description
Payroll Taxes & Expenses Subtotal:
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit C-1
Page 2 of 14
2000: CLIENT SUPPORT
Acct #Amount
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 -
2009 -
2010 -
2011 -
2012 -
2013 -
2014 -
2015 -
2016 -
-$
3000: OPERATING EXPENSES
Acct #Amount
3001 10,200$
3002 1,847
3003 10,350
3004 -
3005 6,500
3006 3,500
3007 -
3008 27,200
3009 150
3010 650
3011 -
3012 -
60,397$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 9,500$
4002 26,500
4003 3,526
4004 25,400
4005 -
4006 6,650
4007 -
4008 -
4009 -
4010 -
71,576$
5000: SPECIAL EXPENSES
Staff Mileage
Subscriptions & Memberships
Clothing, Food, & Hygiene
Other (Specify)
Other (Specify)
Office, Household & Program Supplies
Utility Vouchers
Program Supplies - Medical
Medication Supports
Household Items for Clients
Employment Support
Other (Specify)
Other (Staff Recuitment/Background Checks)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
FACILITIES/EQUIPMENT TOTAL:
OPERATING EXPENSES TOTAL:
Other (Specify)
Advertising
Rent/Lease Building
Building Maintenance
Education Support
Other (Miscellaneous)
Staff Development & Training
Child Care
Rent/Lease Vehicles
Client Transportation & Support
Client Housing Support
Other (Specify)
Other (Specify)
Security
Utilities
Rent/Lease Equipment
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Vehicle Maintenance
Line Item Description
Line Item Description
Line Item Description
DIRECT CLIENT CARE TOTAL
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit C-1
Page 3 of 14
Acct #Amount
5001 38,118$
5002 -
5003 -
5004 100
5005 8,577
5006 -
5007 -
5008 -
46,795$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 143,960$
6002 6,940
6003 -
6004 -
6005 18,500
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
169,400$
7000: FIXED ASSETS
Acct #Amount
7001 7,706$
7002 500
7003 3,000
7004 -
7005 -
7006 -
7007 -
7008 -
11,206$
Payroll Services
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Insurance (Liability):
Other (Specify)
Other Assets over $500 with Lifespan of 2 Years +
Consultant (Network & Data Management)
1,452,686$ TOTAL PROGRAM EXPENSES
FIXED ASSETS EXPENSES TOTAL
ADMINISTRATIVE EXPENSES TOTAL
SPECIAL EXPENSES TOTAL:
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
External Audit
Professional Liability Insurance
Accounting/Bookkeeping
Line Item Description
Contractual/Consulting Services (Specify)
Translation Services
Administrative Overhead
Other (Avatar License Fee)
Other (Specify)
Other (Specify)
Other (Specify)
HMIS (Health Management Information System)
Line Item Description
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Line Item Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit C-1
Page 4 of 14
Acct #Service Units Rate Amount
8001 Mental Health Services 25,000 3.26 81,498$
8002 Case Management 32,474 2.50 81,184
8003 Crisis Services 225,000 5.00 1,125,000
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
282,473 1,287,682$
75%
965,762
50%482,881
482,881$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment -$
-$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports
8302 PEI - Prevention & Early Intervention 969,805
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
969,805$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
8200 - REALIGNMENT
NET PROGRAM COST:
PROGRAM FUNDING SOURCES
TOTAL PROGRAM FUNDING SOURCES:1,452,686$
0$
SUBSTANCE USE DISORDER FUNDS TOTAL
MEDI-CAL FFP TOTAL
MHSA TOTAL
Line Item Description
Line Item Description
8100 - SUBSTANCE USE DISORDER FUNDS
OTHER REVENUE TOTAL
Line Item Description
8400 - OTHER REVENUE
Grants (Specify)
Other (Specify)
Other (Specify)
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Federal Financial Participation (FFP) %
MHSA Program Name
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
Line Item Description
REALIGNMENT TOTAL
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit C-1
Page 5 of 14
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 1,093,312
Employee Salaries 867,902
1101 Program Oversight 33,553 Positions will provide agency specific staff oversight and represent and maintain the
collaborative relationship between agencies. Provide program management and
direction. Ensures operations are running smoothly and in compliance with contract
requirements.
1102 Clinical Supervisor 58,779 Provides supervision of all licenced and unlicensed clinical staff.
1103 Program Manager 71,523 Provides supervision of all staff and direct oversight of program management.
1104 Clinician (2 unlicensed, 5 Licensed)641,516 Assist with managing the client's illness and reduce its impact on the client's life, and
referrals to appropriate linkages.
1105 Per Diem Team Responders (Licensed)37,137 Per Diem-Assist with managing the client's illness and reduce its impact on the
client's life, and referrals to appropriate linkages.
1106 Program Staff Accountant 5,967 Provides budget guidance, monthly invoicing and other fiscal services.
1107 Administrative Support 19,427 Provides administrative support for the program and assist with medical billing and
records.
1108 0 -
1109 0 -
1110 0 -
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 152,506
1201 Retirement 15,364 Cost of 401K
1202 Worker's Compensation 25,883 Workers Comp Insurance
1203 Health Insurance 111,259 Cost of Medical, Vision, Dental, Life and Long Term Disability Insurance
1204 Other (Specify)-
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:72,904
1301 OASDI -
1302 FICA/MEDICARE 66,395 Cost of FICA/Medicare
1303 SUI 6,509 Cost of SUI
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT -
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports -
2009 Program Supplies - Medical -
2010 Utility Vouchers -
2011 Other (Specify)-
2012 Other (Specify)-
2013 Other (Specify)-
Kings View Corporation
Rural Mental Health Triage - East
Fiscal Year (FY 2020-21)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C-1
Page 6 of 14
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 60,397
3001 Telecommunications 10,200 Cost of telephone services, cell phones service, data connectivity.
3002 Printing/Postage 1,847 Aniticapting courier services and postage nesessary for program. Business cards and
other special printing in bulk that is less cost effective to outsource rather than
utilization of a copier.
3003 Office, Household & Program Supplies 10,350 Includes all supplies used by staff in the course of providing services.
3004 Advertising -
3005 Staff Development & Training 6,500 Cost of continuation of staff development and training.
3006 Staff Mileage 3,500 Reimbusements to staff for personal vehicle use when lease vehicle not available
and require to provide services or other program needs, paid at IRS rate. Any travel
transporation fees, such as parking fees.
3007 Subscriptions & Memberships -
3008 Vehicle Maintenance 27,200 Auto repairs & maintenance required to maintain leased vehicles for client
transporation and program needs, such as oil changes and car washes. Yearly cost of
GPS, vehicle tracking service.
3009 Other (Miscellaneous)150 Anticipating minor expense that would not fall under any other category.
3010 Other (Staff Recuitment/Background Checks)650 Thorough background checks and drug testing.
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 71,576
4001 Building Maintenance 9,500 Copier maintenance, inspection services, pest control, alarm services, janitorial
services and minor building repairs and maintenance.
4002 Rent/Lease Building 26,500 Building space lease.
4003 Rent/Lease Equipment 3,526 Copier lease and water dispenser rental.
4004 Rent/Lease Vehicles 25,400 The cost of lease vehicles to assist with program and client needs.
4005 Security -
4006 Utilities 6,650 The cost of gas and electric.
4007 Other (Specify)-
4008 Other (Specify)-
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 46,795
5001 Consultant (Network & Data Management)38,118 Kings View Information Technology Department (KVIT) will provide hardware and
software support for successful data collection. A database will be designed for this
program. KVIT will procure equipment, software & other services from approved &
authorized vendors. Provide online, onsite, or phone-based emergency support-
24/7 from the KVIT Help Desk.
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services (Specify)-
5004 Translation Services 100 Anticipating need of outsource transaltion services.
5005 Other (Avatar License Fee)8,577 Estimated cost of Avatar fees.
5006 Other (Specify)-
5007 Other (Specify)-
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 169,400
6001 Administrative Overhead 143,960 Expenses provides program management, fiscal services, payroll, human resources,
accounts payable and other administrative functions.
6002 Professional Liability Insurance 6,940 Cost general and professional liablity insurance.
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Liability):18,500 Cost of personal property, accidental and auto insurance.
6006 Payroll Services -
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C-1
Page 7 of 14
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS 11,206
7001 Computer Equipment & Software 7,706 Anitipating additional computer equipment needed for new staff and or
replacement. Duo factor licensing and other computer software.
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
500 Anticipating additional equipment cost for new staff and or replacement.
7003 Furniture & Fixtures 3,000 Anticipating additional furniture cost for new staff and or replacement.
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,452,686
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,452,686
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C-1
Page 8 of 14
Employee Salaries
Acct #Position FTE Admin Direct Total
1101 Program Oversight 0.23 -$ 27,387$ 27,387$
1102 Clinical Supervisor 0.45 48,092 48,092
1103 Program Manager 0.45 - 58,519 58,519
1104 Clinician (2 Licensed, 5 Unlicensed) 7.00 - 555,944 555,944
1105 Per Diem Team Responders (Licensed)0.38 - 32,919 32,919
1106 Program Staff Accountant 0.09 - 4,842 4,842
1107 Administrative Support 0.26 - 12,628 12,628
1108 - -
1109 - - -
1110 - - -
1111 - - -
1112 - - -
1113 - - -
1114 - - -
1115 - - -
1116 - - -
1117 - - -
1118 - - -
1119 - - -
1120 - - -
Personnel Salaries Subtotal 8.86 -$ 740,331$ 740,331$
Employee Benefits
Acct #Admin Direct Total
1201 -$ 13,083$ 13,083$
1202 - 22,078 22,078
1203 - 94,739 94,739
1204 - - -
1205 - - -
1206 - - -
-$ 129,900$ 129,900$
Payroll Taxes & Expenses:
Acct #Admin Direct Total
1301 -$ -$ -$
1302 - 56,635 56,635
1303 - 5,553 5,553
1304 - - -
1305 - - -
1306 - - -
-$ 62,188$ 62,188$
-$ 932,419$ 932,419$
Rural Mental Health Triage- West
Kings View Corporation
Fiscal Year (FY 2020-21)
Description
Payroll Taxes & Expenses Subtotal:
Other (Specify)
Other (Specify)
EMPLOYEE SALARIES & BENEFITS TOTAL:
Other (Specify)
Other (Specify)
PROGRAM EXPENSES
1000: SALARIES & BENEFITS
Retirement
Worker's Compensation
Health Insurance
Other (Specify)
Other (Specify)
OASDI
FICA/MEDICARE
SUI
Employee Benefits Subtotal:
Description
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit C-1
Page 9 of 14
2000: CLIENT SUPPORT
Acct #Amount
2001 -$
2002 -
2003 -
2004 -
2005 -
2006 -
2007 -
2008 -
2009 -
2010 -
2011 -
2012 -
2013 -
2014 -
2015 -
2016 -
-$
3000: OPERATING EXPENSES
Acct #Amount
3001 9,591$
3002 1,500
3003 6,500
3004 -
3005 5,000
3006 1,600
3007 -
3008 20,218
3009 150
3010 450
3011 -
3012 -
45,009$
4000: FACILITIES & EQUIPMENT
Acct #Amount
4001 8,000$
4002 23,000
4003 2,200
4004 23,176
4005 -
4006 4,800
4007 -
4008 -
4009 -
4010 -
61,176$
5000: SPECIAL EXPENSES
Security
Utilities
Rent/Lease Equipment
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Vehicle Maintenance
Line Item Description
Line Item Description
Line Item Description
DIRECT CLIENT CARE TOTAL
Other (Specify)
Advertising
Rent/Lease Building
Building Maintenance
Education Support
Other (Miscellaneous)
Staff Development & Training
Child Care
Rent/Lease Vehicles
Client Transportation & Support
Client Housing Support
Other (Specify)
Other (Specify)
FACILITIES/EQUIPMENT TOTAL:
OPERATING EXPENSES TOTAL:
Other (Staff Recuitment/Background Checks)
Other (Specify)
Other (Specify)
Telecommunications
Printing/Postage
Staff Mileage
Subscriptions & Memberships
Clothing, Food, & Hygiene
Other (Specify)
Other (Specify)
Office, Household & Program Supplies
Utility Vouchers
Program Supplies - Medical
Medication Supports
Household Items for Clients
Employment Support
Other (Specify)
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit C-1
Page 10 of 14
Acct #Amount
5001 32,400$
5002 -
5003 -
5004 100
5005 8,577
5006 -
5007 -
5008 -
41,077$
6000: ADMINISTRATIVE EXPENSES
Acct #Amount
6001 116,801$
6002 5,940
6003 -
6004 -
6005 17,500
6006 -
6007 -
6008 -
6009 -
6010 -
6011 -
6012 -
140,241$
7000: FIXED ASSETS
Acct #Amount
7001 7,768$
7002 500
7003 1,000
7004 -
7005 -
7006 -
7007 -
7008 -
9,268$
Other (Specify)
Other (Specify)
Other (Specify)
Other (Specify)
Assets over $5,000/unit (Specify)
Other (Specify)
Other (Specify)
Line Item Description
Administrative Overhead
Other (Avatar License Fee)
Other (Specify)
Other (Specify)
Other (Specify)
HMIS (Health Management Information System)
Line Item Description
Professional Liability Insurance
Accounting/Bookkeeping
Line Item Description
Contractual/Consulting Services (Specify)
Translation Services
1,229,190$ TOTAL PROGRAM EXPENSES
FIXED ASSETS EXPENSES TOTAL
ADMINISTRATIVE EXPENSES TOTAL
SPECIAL EXPENSES TOTAL:
Depreciation (Provider-Owned Equipment to be Used for Program Purposes)
External Audit
Computer Equipment & Software
Copiers, Cell Phones, Tablets, Devices to Contain HIPAA Data
Furniture & Fixtures
Leasehold/Tenant/Building Improvements
Insurance (Liability):
Other (Specify)
Other Assets over $500 with Lifespan of 2 Years +
Consultant (Network & Data Management)
Payroll Services
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit C-1
Page 11 of 14
Acct #Service Units Rate Amount
8001 Mental Health Services 15,955 3.26 52,013$
8002 Case Management 15,000 2.50 37,500
8003 Crisis Services 80,000 5.00 400,000
8004 Medication Support 0 - -
8005 Collateral 0 - -
8006 Plan Development 0 - -
8007 Assessment 0 - -
8008 Rehabilitation 0 - -
110,955 489,513$
75%
367,135
50%183,567
183,567$
Acct #Amount
8101 Drug Medi-Cal -$
8102 SABG -$
-$
Acct #Amount
8201 Realignment -$
-$
Acct #MHSA Component Amount
8301 CSS - Community Services & Supports -$
8302 PEI - Prevention & Early Intervention 1,045,623
8303 INN - Innovations -
8304 WET - Workforce Education & Training -
8305 CFTN - Capital Facilities & Technology -
1,045,623$
Acct #Amount
8401 Client Fees -$
8402 Client Insurance -
8403 -
8404 -
8405 -
-$
Grants (Specify)
Other (Specify)
Other (Specify)
8000 - SHORT/DOYLE MEDI-CAL (FEDERAL FINANCIAL PARTICIPATION)
Estimated Specialty Mental Health Services Billing Totals:
Estimated % of Clients who are Medi-Cal Beneficiaries
Estimated Total Cost of Specialty Mental Health Services Provided to Medi-Cal Beneficiaries
Federal Financial Participation (FFP) %
MHSA Program Name
8300 - MENTAL HEALTH SERVICE ACT (MHSA)
Line Item Description
REALIGNMENT TOTAL
NET PROGRAM COST:
PROGRAM FUNDING SOURCES
TOTAL PROGRAM FUNDING SOURCES:1,229,190$
(0)$
SUBSTANCE USE DISORDER FUNDS TOTAL
MEDI-CAL FFP TOTAL
MHSA TOTAL
Line Item Description
Line Item Description
8100 - SUBSTANCE USE DISORDER FUNDS
OTHER REVENUE TOTAL
Line Item Description
8400 - OTHER REVENUE
8200 - REALIGNMENT
Fresno County Department of Behavioral Health Contract Budget Template Revised 2/7/2020
Revised Exhibit C-1
Page 12 of 14
Budget Narrative
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
1000: SALARIES & BENEFITS 932,419
Employee Salaries 740,331
1101 Program Oversight 27,387 Positions will provide agency specific staff oversight and represent and maintain the
collaborative relationship between agencies. Provide program management and
direction. Ensures operations are running smoothly and in compliance with contract
requirements.
1102 Clinical Supervisor 48,092 Provides supervision of all licenced and unlicensed clinical staff.
1103 Program Manager 58,519 Provides supervision of all staff and direct oversight of program management.
1104 Clinician (2 Licensed, 5 Unlicensed) 555,944 Assist with managing the client's illness and reduce its impact on the client's life, and
referrals to appropriate linkages.
1105 Per Diem Team Responders (Licensed)32,919 Per Diem-Assist with managing the client's illness and reduce its impact on the
client's life, and referrals to appropriate linkages.
1106 Program Staff Accountant 4,842 Provides budget guidance, monthly invoicing and other fiscal services.
1107 Administrative Support 12,628 Provides administrative support for the program and assist with medical billing and
records.
1108 0 -
1109 0 -
1110 0 -
1111 0 -
1112 0 -
1113 0 -
1114 0 -
1115 0 -
1116 0 -
1117 0 -
1118 0 -
1119 0 -
1120 0 -
Employee Benefits 129,900
1201 Retirement 13,083 Cost of 401K
1202 Worker's Compensation 22,078 Workers Comp Insurance
1203 Health Insurance 94,739 Cost of Medical, Vision, Dental, Life and Long Term Disability Insurance
1204 Other (Specify)-
1205 Other (Specify)-
1206 Other (Specify)-
Payroll Taxes & Expenses:62,188
1301 OASDI -
1302 FICA/MEDICARE 56,635 Cost of FICA/Medicare
1303 SUI 5,553 Cost of SUI
1304 Other (Specify)-
1305 Other (Specify)-
1306 Other (Specify)-
2000: CLIENT SUPPORT -
2001 Child Care -
2002 Client Housing Support -
2003 Client Transportation & Support -
2004 Clothing, Food, & Hygiene -
2005 Education Support -
2006 Employment Support -
2007 Household Items for Clients -
2008 Medication Supports -
2009 Program Supplies - Medical -
2010 Utility Vouchers -
2011 Other (Specify)-
2012 Other (Specify)-
2013 Other (Specify)-
Kings View Corporation
Rural Mental Health Triage- West
Fiscal Year (FY 2020-21)
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C-1
Page 13 of 14
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
2014 Other (Specify)-
2015 Other (Specify)-
2016 Other (Specify)-
3000: OPERATING EXPENSES 45,009
3001 Telecommunications 9,591 Cost of telephone services, cell phones service, data connectivity.
3002 Printing/Postage 1,500 Aniticapting courier services and postage nesessary for program. Business cards and
other special printing in bulk that is less cost effective to outsource rather than
utilization of a copier.
3003 Office, Household & Program Supplies 6,500 Includes all supplies used by staff in the course of providing services.
3004 Advertising -
3005 Staff Development & Training 5,000 Cost of continuation of staff development and training.
3006 Staff Mileage 1,600 Reimbusements to staff for personal vehicle use when lease vehicle not available
and require to provide services or other program needs, paid at IRS rate. Any travel
transporation fees, such as parking fees.
3007 Subscriptions & Memberships -
3008 Vehicle Maintenance 20,218 Auto repairs & maintenance required to maintain leased vehicles for client
transporation and program needs, such as oil changes and car washes. Yearly cost of
GPS, vehicle tracking service.
3009 Other (Miscellaneous)150 Anticipating minor expense that would not fall under any other category.
3010 Other (Staff Recuitment/Background Checks)450 Thorough background checks and drug testing.
3011 Other (Specify)-
3012 Other (Specify)-
4000: FACILITIES & EQUIPMENT 61,176
4001 Building Maintenance 8,000 Copier maintenance, inspection services, pest control, alarm services, janitorial
services and minor building repairs and maintenance.
4002 Rent/Lease Building 23,000 Building space lease.
4003 Rent/Lease Equipment 2,200 Copier lease and water dispenser rental.
4004 Rent/Lease Vehicles 23,176 The cost of lease vehicles to assist with program and client needs.
4005 Security -
4006 Utilities 4,800 The cost of gas and electric.
4007 Other (Specify)-
4008 Other (Specify)-
4009 Other (Specify)-
4010 Other (Specify)-
5000: SPECIAL EXPENSES 41,077
5001 Consultant (Network & Data Management)32,400 Kings View Information Technology Department (KVIT) will provide hardware and
software support for successful data collection. A database will be designed for this
program. KVIT will procure equipment, software & other services from approved &
authorized vendors. Provide online, onsite, or phone-based emergency support-
24/7 from the KVIT Help Desk.
5002 HMIS (Health Management Information
System)
-
5003 Contractual/Consulting Services (Specify)-
5004 Translation Services 100 Anticipating need of outsource transaltion services.
5005 Other (Avatar License Fee)8,577 Estimated cost of Avatar fees.
5006 Other (Specify)-
5007 Other (Specify)-
5008 Other (Specify)-
6000: ADMINISTRATIVE EXPENSES 140,241
6001 Administrative Overhead 116,801 Expenses provides program management, fiscal services, payroll, human resources,
accounts payable and other administrative functions.
6002 Professional Liability Insurance 5,940 Cost general and professional liablity insurance.
6003 Accounting/Bookkeeping -
6004 External Audit -
6005 Insurance (Liability):17,500 Cost of personal property, accidental and auto insurance.
6006 Payroll Services -
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020
Revised Exhibit C-1
Page 14 of 14
ACCT #LINE ITEM AMT DETAILED DESCRIPTION OF ITEMS BUDGETED IN EACH ACCOUNT LINE
6007 Depreciation (Provider-Owned Equipment to
be Used for Program Purposes)
-
6008 Other (Specify)-
6009 Other (Specify)-
6010 Other (Specify)-
6011 Other (Specify)-
6012 Other (Specify)-
7000: FIXED ASSETS 9,268
7001 Computer Equipment & Software 7,768 Anitipating additional computer equipment needed for new staff and or
replacement. Duo factor licensing and other computer software.
7002 Copiers, Cell Phones, Tablets, Devices to
Contain HIPAA Data
500 Anticipating additional equipment cost for new staff and or replacement.
7003 Furniture & Fixtures 1,000 Anticipating additional furniture cost for new staff and or replacement.
7004 Leasehold/Tenant/Building Improvements -
7005 Other Assets over $500 with Lifespan of 2
Years +
-
7006 Assets over $5,000/unit (Specify)-
7007 Other (Specify)-
7008 Other (Specify)-
TOTAL PROGRAM EXPENSE FROM BUDGET NARRATIVE:1,229,190
TOTAL PROGRAM EXPENSES FROM BUDGET TEMPLATE:1,229,190
-
Fresno County Department of Behavioral Health Contract Budget Narrative Revised 2/7/2020